92-100385CITY OF
FEDERAL WAY
MECHANICAL PERMIT
BUILDING PERMIT
q.?, )003&5'
BUILDING INSPECTION
941-1555
PERMIT NO. 92-0363 M OWNER'S NAME BECKY GABRUK JOB ADDRESS 33200 35TH AVE SW
CONTRACTOR JOHN'S FURANCE CO
ADDRESS 1032 S. GEIGER TACOMA CONT. PHONE 564-4265
CONT. REG. NO. JOHNSF151LS
OWNER'S PHONE 838-7097 OWNER'S ADDRESS 33200 35TH AVE SW FEDERAL WAY
TYPE JOB: NEW RESIDENCE ADDITION
NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC
PUBLIC ADD.
NEW MULTI -FAMILY (UNITS ) MULTI. ADD.
SIGN GRADING OTHER
TAX ACCOUNT NO. 109957-0190
LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSON
DATE OF ISSUE DATE OF APPLICATION 5-9-92
BUILDING INFORMATION
ZONE OCCUPANCY
TYPE OF CONSTRUCTION BLDG. SQ. FT.
SET BACKS: FRONT
SIDE REAR STORIES HEIGHT LIMIT
PLUMBING NO.
NO. MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING -2a FT. 2_0 BOILER
BATHTUBS LAUNDRY DRAINS COMPRESSOR RAN('F: TANK(S) 6-50
RECEIVED
SHOWERS URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES DRINKING FOUNTAINS
GAS POT WATER HTR. MISC.
SINKS MISC.
CONVERSION BURNER BASIC FEE 20.00
RETURNED
DISHWASHERS TOTAL FIXTURES UNIT HEATER TOTAL MECHANICAL 28.50
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT
SUFFICE.
PERMIT FEE
PLAN CHECK FEE
UMBING FEE
INSPECTION RECORD
CHANICAL FEE 28.50
TOTAL BLDG. FEES
Water Line OK Mechanical Inspection Notes:
PART P/C FEE
SEPA REVIEW
GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
MECHANICAL PERMIT
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE 28.50
Account No. 010-000-322-10-004 Total Fee $ 28.50 Receipt No.
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
RjEQUIREMENTS WILL BE �E2�
/
OWNER OR AGENT
DATE ��
i7
P it # f1C,4
RF OVER CITY OF FEDERAL WAY
MAR 0 9 1992 BUILDING PERMIT APPLICATION
i0v (W �K0y�FRAL WAy — Please Print —
a "I Ow Oak
BOX 1 TENANT NAME: —
OWNER ; c°� 6r,t-8 RQ 1< SITE LOCATION 3 3,;) c u " 3 S- 77f /file. Sc _'.
OWNER'S ADDRESS 3 3- �� - 3 y IP1 = c 1 CITY/_ V- 4- [: /� PHONE Y 3 P " 7c 7
DESCRIBE JOB
THE PROPERTY IS OWNED BY: SINGLE ARRIED) PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME
CONTRACTOR'S REG. #.
Card MUST be presented
CONTRACTOR'S ADDRESS _1 Z SL' ' C''�� CITY / c PHONEOe'6 -S-1
EXPIRATION DATE �� Z'y --� �-
—OR—
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
eiA>
BOX 3 CONTACT PERSON PHONE
BOX 4 SEWER DISTRICT
WATER DISTRICT
--` BOX 5 ESTIMATED PROJECT COST `- EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUM
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
-BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR%lec / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 SINGLE FAMILY ( ) NEW CONSTRUCTION
MULTIFAMILY (NO. OF UNITS = ) tX EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICALAPPLIANCES — BASIC FEE $
N0. WATERCLOSETS
GAS PIPING, FEET -2-5s $
BATHTUBS
N0. FURNACE, ELEC. GAS $
_SHOWERS
GAS HOT WATER HEATER $
LAVATORIES
CONVERSION BURNER $
SINKS
BOILER, SIZE BTU $
DISHWASHERS
AIR HANDLING UNITS $
ELECTRIC HOT WATER HEATER
HEAT PUMPS, SIZE $
LAUNDRY WASHER OUTLET
UNIT HEATERS $
URINALS
AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS
COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS
—OTHER
DRAINS
$
OTHER
$
TOTAL FIXTURES
$
TOTAL MECHANICAL FEE $
I CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION
FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE
PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
MADE. I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM (INCLUDING COSTS, EXPENSES, AND ATTORNEYS'
FEES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM),
WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
AND FILED AGAINST THE CITY OF FEDERAL WAY, BUT ONLY WHERE
SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOYEES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
�" y�'�
OWNER/AGENT:
DATE:�-�-
ANP -006 3/90
OFFICE USE ONLY (PLEASE DO NOT WRITE BELOW0S LINE)
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS:
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DATE
REMARKS:
PUBLIC WORKS DEPARTMENT APPROVAL DATE
REMARKS:
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ADD/ALT NEW MULTIFAMILY (UNITS )
MULTIFAMILY ADD/ALT TENANT IMP. OTHER
OCCUPANCY TYPE OF CONSTRUCTION STORES
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING DEPARTMENT REMARKS:
MAR 0 9 1992
tsar a
RECEIVED
ASSIGNED ADDRESS:
PARTIAL PLAN CHECK FEE RECEIVED
Amount Date Receipt #
BUILDING DEPARTMENT APPROVAL
BY DATE_
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
ACCEPTED FOR FILING
MECHANICAL PERMIT
CITY OF BUILDING PERMIT BUILDING INSPECTION
FEDERAL WAY 941-1555
PERMIT NO.
OWNER'S NAME JOB ADDRESS
CONTRACTOR
ADDRESS
CONT PHONE
CONT. REG. NO.
OWNER'S PHONE OWNER'S ADDRESS
TYPE JOB: NEW RESIDENCE
ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI -FAMILY (UNITS
) MULTI. ADD. SIGN GRADING OTHER
TAX ACCOUNT NO.
LEGAL DESCRIPTION
dh
ISSUED BY
DATE OF ISSUE DATE OF APPLICATION
BUILDING INFORMATION
ONE
OCCUPANCY TYPE OF CONSTRUCTION
BLDG. S0. FT.
ET BACKS: FRONT
IP
SIDE REAR STORIES
HEIGHT LIMIT
LUMBING NO.
NO.
MECHANICAL APPLIANCES AMT.
AMT.
BOND
WATER CLOSETS
ELEC. HOT WATER HEATER
GAS PIPING FT. BOILER
RECEIVED
BATHTUBS
LAUNDRY DRAINS
COMPRESSOR TANK(S)
SHOWERS
URINALS
FORCED AIR FURNACE AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
GAS RIOT WATER HTR. MISC.
RETURNED
SINKS
MISC.
CONVERSION BURNER BASIC FEE
DISHWASHERS
TOTAL FIXTURES
UNIT HEATER TOTAL MECHANICAL
AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR.
AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN CHECK FEE
LUMBING FEE
INSPECTION RECORD
CHANICAL FEE
TOTAL BLDG, FEES
PART PIC FEE
SEPA REVIEW
Water Line OK Mechanical Inspection
GAS PIPING OK 2 _'I� Date % y
Notes:
WATER SERVICE
_
WATER MAIN CHG.
MECHANICAL PERMIT
!
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
Account No. 010-000-322-10-004 Total Fee $
Receipt No.
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE MET:
OWNER OR AGENT
DATE
0
C�
SET BACKS AND FOOTINGS
DATE . _ . _-_ BY _ _
OX TO POUR FOUNDATION WALLS
DATE _- --_... _ BY ....
PLUMBING GROUNDWORK
DATE____BY _ _-
PLUMBING ROUGH IN
DATE ..__ - -BY
WATER LINE O.K.
GAS PIPING
__
MECHANICAL INSPECTION
DATE -
O.K. TO ENCLOSE FRAMING
DATE ...... ___- ........ _.._BY _ -
INSULATION
DATE ..... - .... _BY
_-.._.._
WALL BOARD AND FIRE WALL
DATE ...._.__ __ BY
FINAL O.K. TO OCCUPY
DATE __ '�Z BY/Y -
DCD
PSD
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